{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:16:04Z","timestamp":1791555364048,"version":"4.3.4"},"reference-count":47,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T00:00:00Z","timestamp":1643587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFMK"],"abstract":"<jats:p>Hamstring strains are a frequent injury in sports and are characterized by a high recurrence rate. The aim of this review was to examine the muscle and tendon architecture in individuals with hamstring injury. A systematic literature search in four databases yielded eleven studies on architecture following injury. Differences in the fascicle length (FL), pennation angle (PA) and muscle size measures (volume, thickness and physiological cross-sectional area) at rest were not significantly different between the previously injured limb and the contralateral limb (p &gt; 0.05). There was moderate evidence that biceps femoris long head (BFlh) FL shortening was greater during contraction in the injured compared to the contralateral limb. The BFlh FL was smaller in athletes with a previous injury compared to uninjured individuals (p = 0.0015) but no differences in the FL and PA of other muscles as well as in the aponeurosis\/tendon size were observed (p &gt; 0.05). An examination of the FL of both leg muscles in individuals with a previous hamstring strain may be necessary before and after return to sport. Exercises that promote fascicle lengthening of both injured and uninjured leg muscles may be beneficial for athletes who recover from a hamstring injury.<\/jats:p>","DOI":"10.3390\/jfmk7010016","type":"journal-article","created":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T09:59:21Z","timestamp":1643709561000},"page":"16","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Is Muscle Architecture Different in Athletes with a Previous Hamstring Strain? A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8179-6340","authenticated-orcid":false,"given":"Eleftherios","family":"Kellis","sequence":"first","affiliation":[{"name":"Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, 62100 Serres, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5974-7948","authenticated-orcid":false,"given":"Chrysostomos","family":"Sahinis","sequence":"additional","affiliation":[{"name":"Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, 62100 Serres, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1136\/bjsports-2015-095359","article-title":"Hamstring injuries have increased by 4% annually in men\u2019s professional football, since 2001: A 13-year longitudinal analysis of the UEFA Elite Club injury study","volume":"50","author":"Ekstrand","year":"2016","journal-title":"Br. J. Sports Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1111\/j.1600-0838.2012.01487.x","article-title":"Risk Factors for Hamstring Injuries in Male Soccer Players: A Systematic Review of Prospective Studies","volume":"23","author":"Vereijken","year":"2013","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1177\/0363546509358381","article-title":"Intrinsic Risk Factors for Hamstring Injuries Among Male Soccer Players: A Prospective Cohort Study","volume":"38","author":"Myklebust","year":"2010","journal-title":"Am. J. Sports Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/j.1600-0838.2008.00780.x","article-title":"Muscular strength, functional performances and injury risk in professional and junior elite soccer players","volume":"19","author":"Lehance","year":"2009","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1249\/01.MSS.0000117165.75832.05","article-title":"Predicting hamstring strain injury in elite athletes","volume":"36","author":"Brockett","year":"2004","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1249\/MSS.0b013e3182776eff","article-title":"Hamstring strength and morphology progression after return to sport from injury","volume":"45","author":"Sanfilippo","year":"2013","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"284","DOI":"10.2519\/jospt.2013.4452","article-title":"Clinical and morphological changes following 2 rehabilitation programs for acute hamstring strain injuries: A randomized clinical trial","volume":"43","author":"Silder","year":"2013","journal-title":"J. Orthop. Sport. Phys. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1136\/bjsports-2015-095311","article-title":"Hamstring strength and flexibility after hamstring strain injury: A systematic review and meta-analysis","volume":"50","author":"Maniar","year":"2016","journal-title":"Br. J. Sports Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.jelekin.2012.11.004","article-title":"Knee flexor strength and bicep femoris electromyographical activity is lower in previously strained hamstrings","volume":"23","author":"Opar","year":"2013","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1177\/0363546512462809","article-title":"Rate of torque and electromyographic development during anticipated eccentric contraction is lower in previously strained hamstrings","volume":"41","author":"Opar","year":"2013","journal-title":"Am. J. Sports Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"37","DOI":"10.2165\/00007256-199825010-00004","article-title":"Quantification of quadriceps and hamstring antagonist activity","volume":"25","author":"Kellis","year":"1998","journal-title":"Sport. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2271","DOI":"10.1007\/s40279-018-0975-4","article-title":"Intra- and Inter-Muscular Variations in Hamstring Architecture and Mechanics and Their Implications for Injury: A Narrative Review","volume":"48","author":"Kellis","year":"2018","journal-title":"Sport. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"975","DOI":"10.2214\/ajr.183.4.1830975","article-title":"Longitudinal study comparing sonographic and MRI assessments of acute and healing hamstring injuries","volume":"183","author":"Connell","year":"2004","journal-title":"Am. J. Roentgenol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.2214\/ajr.179.6.1791621","article-title":"Hamstring injury in athletes: Using MR imaging measurements to compare extent of muscle injury with amount of time lost from competition","volume":"179","author":"Slavotinek","year":"2002","journal-title":"Am. J. Roentgenol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1007\/s00256-003-0674-5","article-title":"Evaluation of the hamstring muscle complex following acute injury","volume":"32","author":"Koulouris","year":"2003","journal-title":"Skelet. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Canosa-Carro, L., Bravo-Aguilar, M., Abu\u00edn-Porras, V., Almaz\u00e1n-Polo, J., Garc\u00eda-P\u00e9rez-de-Sevilla, G., Rodr\u00edguez-Costa, I., L\u00f3pez-L\u00f3pez, D., Navarro-Flores, E., and Romero-Morales, C. (2022). Current understanding of the diagnosis and management of the tendinopathy: An update from the lab to the clinical practice. Disease-a-Month, 101314.","DOI":"10.1016\/j.disamonth.2021.101314"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2311","DOI":"10.1007\/s40279-021-01487-w","article-title":"Muscle Activity and Activation in Previously Strain-Injured Lower Limbs: A Systematic Review","volume":"51","author":"Presland","year":"2021","journal-title":"Sports Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1249\/MSS.0000000000000507","article-title":"Biceps femoris long head architecture: A reliability and retrospective injury study","volume":"47","author":"Timmins","year":"2015","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1080\/24733938.2020.1751871","article-title":"Flexibility, strength, and fascicle length of football players with and without history of hamstring strain injury in the prior season","volume":"4","author":"Oliveira","year":"2020","journal-title":"Sci. Med. Footb."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2150007","DOI":"10.1142\/S021951942150007X","article-title":"Hamstring muscle architecture and viscoelastic properties: Reliability and retrospective comparison between previously injured and uninjured athletes","volume":"21","author":"Nin","year":"2021","journal-title":"J. Mech. Med. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2102","DOI":"10.1249\/MSS.0000000000001333","article-title":"Effect of prior injury on changes to biceps femoris architecture across an australian football league season","volume":"49","author":"Timmins","year":"2017","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1152\/japplphysiol.00411.2019","article-title":"Bilateral differences in hamstring coordination in previously injured elite athletes","volume":"128","author":"Avrillon","year":"2020","journal-title":"J. Appl. Physiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.clinbiomech.2010.04.015","article-title":"Effects of prior hamstring strain injury on strength, flexibility, and running mechanics","volume":"25","author":"Silder","year":"2010","journal-title":"Clin. Biomech."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1055\/a-1028-7322","article-title":"Is Biceps Femoris Aponeurosis Size an Independent Risk Factor for Strain Injury?","volume":"41","author":"Freitas","year":"2020","journal-title":"Int. J. Sports Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2574","DOI":"10.1016\/j.jbiomech.2010.05.011","article-title":"The effects of aponeurosis geometry on strain injury susceptibility explored with a 3D muscle model","volume":"43","author":"Rehorn","year":"2010","journal-title":"J. Biomech."},{"key":"ref_26","first-page":"1","article-title":"Sports Injury prevention: A concise review","volume":"1","author":"Tarantino","year":"2019","journal-title":"Pharmacologyonline"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1136\/jech.52.6.377","article-title":"The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions","volume":"52","author":"Downs","year":"1998","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1136\/bjsports-2011-090664","article-title":"Risk factors for hamstring muscle strain injury in sport: A systematic review and meta-analysis","volume":"47","author":"Freckleton","year":"2013","journal-title":"Br. J. Sports Med."},{"key":"ref_29","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Lawrence Erlbaum Associates, Publishers. [2nd ed.]."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Higgins, J.P.T., and Green, S. (2008). Cochrane Handbook for Systematic Reviews of Interventions, Wiley-Blackwell.","DOI":"10.1002\/9780470712184"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1136\/bmj.323.7304.101","article-title":"Systematic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis","volume":"323","author":"Sterne","year":"2001","journal-title":"BMJ"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1136\/bjsports-2017-098101","article-title":"Isokinetic strength assessment offers limited predictive validity for detecting risk of future hamstring strain in sport: A systematic review and meta-analysis","volume":"52","author":"Green","year":"2018","journal-title":"Br. J. Sports Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2663","DOI":"10.1177\/0363546515599633","article-title":"Eccentric knee flexor strength and risk of hamstring injuries in rugby union","volume":"43","author":"Bourne","year":"2015","journal-title":"Am. J. Sports Med."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"M\u00fchlenfeld, N., Steendahl, I.B., Berthold, D.P., Meyer, T., Hauser, T., Wagner, N., Sander, A.-L., Marzi, I., Kaltenbach, B., and Yel, I. (2021). Assessment of muscle volume using magnetic resonance imaging (MRI) in football players after hamstring injuries. Eur. J. Sport Sci., 1\u20139.","DOI":"10.1080\/17461391.2021.1942226"},{"key":"ref_35","first-page":"63","article-title":"Change in muscle thickness under contracting conditions following return to sports after a hamstring muscle strain injury\u2014A pilot study","volume":"2","author":"Nagano","year":"2015","journal-title":"Asia-Pac. J. Sport. Med. Arthrosc. Rehabil. Technol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1111\/sms.12494","article-title":"Muscle activation patterns in the Nordic hamstring exercise: Impact of prior strain injury","volume":"26","author":"Bourne","year":"2016","journal-title":"Scand. J. Med. Sci. Sport."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2254","DOI":"10.1016\/j.jbiomech.2010.02.038","article-title":"The influence of prior hamstring injury on lengthening muscle tissue mechanics","volume":"43","author":"Silder","year":"2010","journal-title":"J. Biomech."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.jelekin.2012.12.006","article-title":"The role of neuromuscular inhibition in hamstring strain injury recurrence","volume":"23","author":"Fyfe","year":"2013","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1136\/bjsm.2010.079343","article-title":"Altered muscle activation following hamstring injuries","volume":"46","author":"Sole","year":"2012","journal-title":"Br. J. Sports Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"354","DOI":"10.2519\/jospt.2011.3268","article-title":"Selective Strength Loss and Decreased Muscle Activity in Hamstring Injury","volume":"41","author":"Sole","year":"2011","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1136\/bjsports-2015-095362","article-title":"Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): A prospective cohort study","volume":"50","author":"Timmins","year":"2016","journal-title":"Br. J. Sports Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2549","DOI":"10.1016\/j.jbiomech.2009.07.011","article-title":"Validity of architectural properties of the hamstring muscles: Correlation of ultrasound findings with cadaveric dissection","volume":"42","author":"Kellis","year":"2009","journal-title":"J. Biomech."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"152","DOI":"10.11152\/mu-2302","article-title":"Intra- and inter-muscular differences in the cross-sectional area of the quadriceps muscles assessed by extended field-of-view ultrasonography","volume":"22","author":"Sahinis","year":"2020","journal-title":"Med. Ultrason."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1152\/japplphysiol.00611.2012","article-title":"Heterogeneous atrophy occurs within individual lower limb muscles during 60 days of bed rest","volume":"113","author":"Miokovic","year":"2012","journal-title":"J. Appl. Physiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"209","DOI":"10.2165\/11594800-000000000-00000","article-title":"Hamstring strain injuries: Factors that lead to injury and re-injury","volume":"42","author":"Opar","year":"2012","journal-title":"Sports Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e299","DOI":"10.1111\/sms.12171","article-title":"Reduced biceps femoris myoelectrical activity influences eccentric knee flexor weakness after repeat sprint running","volume":"24","author":"Timmins","year":"2014","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Doral, M., and Karlsson, J. (2015). Acute hamstring muscle injury: Types, rehabilitation, and return to sports. Sports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation, Springer. [2nd ed.].","DOI":"10.1007\/978-3-642-36569-0"}],"container-title":["Journal of Functional Morphology and Kinesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2411-5142\/7\/1\/16\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:12:04Z","timestamp":1760134324000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2411-5142\/7\/1\/16"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,31]]},"references-count":47,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["jfmk7010016"],"URL":"https:\/\/doi.org\/10.3390\/jfmk7010016","relation":{},"ISSN":["2411-5142"],"issn-type":[{"value":"2411-5142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,31]]}}}